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. 2022 Aug 25:10:987228.
doi: 10.3389/fped.2022.987228. eCollection 2022.

Parental participation in the care of hospitalized neonates in low- and middle-income countries: A systematic review and meta-analysis

Anna Reiter  1 , Julie De Meulemeester  1 , Nathan Kenya-Mugisha  2 , Abner Tagoola  3 , Olive Kabajaasi  2 , Matthew O Wiens  2   4   5 , Jessica Duby  6
Affiliations

Parental participation in the care of hospitalized neonates in low- and middle-income countries: A systematic review and meta-analysis

Anna Reiter et al. Front Pediatr. .

Abstract

Introduction: To determine the effect of parental participation in hospital care on neonatal and parental outcomes in low- and middle-income countries (LMICs) and to identify the range of parental duties in the care of hospitalized neonates in LMICs.

Methods: We searched CINAHL, CENTRAL, LILACs, MEDLINE, EMBASE and Web of Science from inception to February 2022. Randomized and non-randomized studies from LMICs were eligible if parents performed one or more roles traditionally undertaken by healthcare staff. The primary outcome was hospital length-of-stay. Secondary outcomes included mortality, readmission, breastfeeding, growth, development and parental well-being. Data was extracted in duplicate by two independent reviewers using a piloted extraction form.

Results: Eighteen studies (eight randomized and ten non-randomized) were included from seven middle-income countries. The types of parental participation included hygiene and infection prevention, feeding, monitoring and documentation, respiratory care, developmental care, medication administration and decision making. Meta-analyses showed that parental participation was not associated with hospital length-of-stay (MD -2.35, 95% CI -6.78-2.07). However, parental involvement was associated with decreased mortality (OR 0.46, 95% CI 0.22-0.95), increased breastfeeding (OR 2.97 95% CI 1.65-5.35) and decreased hospital readmission (OR 0.36, 95% CI 0.16-0.81). Narrative synthesis demonstrated additional benefits for growth, short-term neurodevelopment and parental well-being. Ten of the eighteen studies had a high risk of bias.

Conclusion: Parental participation in neonatal hospital care is associated with improvement in several key neonatal outcomes in middle-income countries. The lack of data from low-income countries suggests that there remains barriers to parental participation in resource-poor settings.

Systematic review registration: [https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=187562], identifier [CRD42020187562].

Keywords: family nursing; infant; nursing; parents; patient-centered care.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
PRISMA flow diagram.
FIGURE 2
FIGURE 2
Forest plot and meta-analysis of the association between parental participation and length of stay.
FIGURE 3
FIGURE 3
Forest plot and meta-analysis of the association between parental participation and mortality.
FIGURE 4
FIGURE 4
Forest plot and meta-analysis of the association between parental participation and nosocomial infection.
FIGURE 5
FIGURE 5
Forest plot and meta-analysis of the association between parental participation and breastfeeding during hospitalization.
FIGURE 6
FIGURE 6
Forest plot and meta-analysis of the association between parental participation and hospital readmission.
See this image and copyright information in PMC

References

    1. Un Inter-agency Group for Child Mortality and Estimation. Levels & Trends in Child Mortality Report 2021. (2021). Available online at: https://www.who.int/publications/m/item/levels-and-trends-in-child-morta... (accessed July 1, 2022).
    1. World Health Organization. Standards for Improving Quality of Maternal and Newborn Care in Health Facilities. (2016). Available online at: https://cdn.who.int/media/docs/default-source/mca-documents/qoc/quality-... (accessed July 1, 2022).
    1. World Health Organization. Global Health Workforce Statistics. Digital Repository. (2018). Available online at: https://www.who.int/data/gho/data/themes/topics/health-workforce (accessed July 1, 2022).
    1. Conde-Agudelo A, Díaz-Rossello JL. Kangaroo mother care to reduce morbidity and mortality in low birthweight infants. Cochrane Database Syst Rev. (2016) 2016:CD002771. 10.1002/14651858.CD002771.pub4 - DOI - PubMed
    1. Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. (2015) 4:1–9. 10.1186/2046-4053-4-1 - DOI - PMC - PubMed

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